Medical case manager: the nursing specialism you’ve probably never heard of

When people ask about my job, I often say the hardest part is explaining what I do. 

Many are surprised to learn that nursing goes beyond hospitals and clinics and often extends into the corporate world. If a business operates within the medical field, it will need to employ medical professionals with the required expertise and knowledge. Medical case management at Healix is such a role. Simply put, it’s essential to ensure that patients, no matter where they are in the world, receive the care they need while balancing medical and financial considerations.

"My role shows that nursing has many avenues beyond working in hospitals. It creates new opportunities and experiences to develop your career that would otherwise not be available in a clinical setting!"

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What is medical case management and how does it relate to nursing?

Medical case management is a vital part of the medical assistance industry that helps individuals who are travelling, whether for business or leisure, and have become ill or injured abroad.

At Healix, we work with business and leisure travellers who are taken ill overseas and their cases come to us via their travel insurance. We collaborate with all stakeholders: including patients, healthcare providers, hospitals and clinics, underwriters and insurance companies to ensure seamless coordination and comprehensive care. Our goal is to make sure they receive appropriate care overseas and that the treatment is medically effective and cost-efficient for the insurance companies involved.

Why are nurses ideally suited for this role?

Nurses bring their expertise in clinical care to assess medical reports and ensure patients, no matter where they are in the world, are receiving appropriate treatment. We review medical reports and speak to the overseas treating physicians about the care they are providing. Nurses assess the medical information and then make recommendations to all parties. For example, a travelling employee has a fractured neck or femur in Spain and the Healix assessment deciphers that surgery is required as soon as possible. We’ve established good local health care providers where this surgery can take place and can be financially covered. This is an oversimplified example, but you can start to understand the role our nurses play.

Medical repatriation is another side of the role nurses have in the medical assistance industry. In some cases, patients require special assistance to travel home, whether through a private air ambulance or a commercial flight with a nurse escort, ensuring safe transport back to their home country. While medical case management is a hybrid office-based job, flight nursing represents the clinical side of the role by flying out and providing care to the patient on their repatriation.